KEGAL EXERCISES

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anxiety out the roof
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Date Joined Aug 2010
Total Posts : 111
   Posted 2/9/2011 4:11 PM (GMT -6)   
FYI- Johns Hopkins tells it's patients to do the Kegal exercises only  when peeing. Get a good stream going, shut it down, repeat. I was told the muscles fatigue easily and too much will make it worse latter in the day. It seems to be working for me.

142
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Date Joined Jan 2010
Total Posts : 6949
   Posted 2/9/2011 4:22 PM (GMT -6)   
Interesting. Exactly the opposite of what I have seen.
 
I was instructed to try the "stop the stream" exercise in order to figure out if I was doing them right, but after that, to do them once the bladder was empty, or just when I think of it.
 
There has been discussion that always doing them while peeing actually can confuse the nerve/muscle coordination.
 
Yes, too many are too many, at least in my experience. I was told to start with 5 setps of 10 reps, but would start leaking badly late in the day. Backing off to 3 or 4 sets a day improved things.

tatt2man
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Date Joined Jan 2010
Total Posts : 2842
   Posted 2/9/2011 4:53 PM (GMT -6)   
my urologist routine is - 20 reps - 5 times a day - basically a standing pelvic thrust like "the time warp" from rocky horror picture show"....
Age: 55 - gay with spouse of 14 years, Steve
location: Peterborough, Ontario, Canada
PSA: 10/06/09 - 3.86
Biopsy: 10/16/09- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/09
Pathology: pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA: 04/08/10 -0.05 -Zero Club
PSA: 09/23/10 -0.05 -Zero Club
PSA: 03/12/11 - TBA

ChrisR
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Date Joined Apr 2008
Total Posts : 825
   Posted 2/9/2011 6:36 PM (GMT -6)   
Actually, I was wondering why I only seem leak when I get home after work. I don't think it's because of all the bills in my mailbox either. It seems in the morning through the afternoon I am dry, but at home I really start to leak. I recently stopped doing kegels all day, just go lazy, and I seem much dryer at night now.
Dx @ 42 years old on 4/2008
Gleason 6 (50 Point Biopsy) (6 Cores positive - Small Focus Each)
open RP 10/08 Johns Hopkins
pT2 Organ Confined Gleason 6 (tertiary score 0)
PSA Since Surgery
1/15/2009 (3 Month) <.1
10/15/2009 (1 Year) <.1
10/15/2010 (2 Year) <0.03
10/15/2011 (3 Year) -

DaSlink
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Date Joined Feb 2011
Total Posts : 713
   Posted 2/11/2011 1:28 PM (GMT -6)   
I just would like to know how long I might have to wait to get my first normal stream. Catheter out almost 5 days and waiting.

Sleepless09
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Date Joined Jul 2009
Total Posts : 1267
   Posted 2/11/2011 2:07 PM (GMT -6)   
I am totally convinced, based on no evidence, or medical advice at all, that a strict regimen of Kegel exercises, religiously followed, and bragged about to all who will listen, will have most all RP patients dry in 180 days.

On the other hand, if you don't bother at all, and just let nature take its course and the body do its thing when it's ready, most all RP patients will be dry in six months.

So take your choice. Believers are cured within days (say 180) while the lazy skeptics could take months (say six.)

My wife is a believer, and so she had me on a Kegel schedule, and reminded me constantly. I lied. Never did a one. But, she was happy, and now when we meet up with other our age who are headed for an RP she admonishes them to do their Kegels and points to me as being a prime example of drying up quickly, thanks to the good Doctor Arnold Kegel. And, I'm not so foolish to argue.

Further, I won't attend any GFMPH event with her anywhere within 1,000 miles without signed, sworn, promises not to reveal my true Kegel history. Life is too short to spend the next couple of years in a rehab hospital.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 2/11/2011 2:51 PM (GMT -6)   
Sleepless09 said...
I am totally convinced, based on no evidence, or medical advice at all, that a strict regimen of Kegel exercises, religiously followed, and bragged about to all who will listen, will have most all RP patients dry in 180 days.

 

 

Sheldon, your study size of 1 might make for good discussion around the GFMPH firepit with a few beers, but for any readers who are interested in knowing (especially those who might have recently had RP surgery) whether Kegels really do have an effect, there have been studies (published in medical journals; abstract available on pubmed.gov) of larger sample sizes which conclude that there are statistically significantly differences in the time to regain continence between populations that do perform Kegels regularly, and those that do not.

The study's conclusion stated that doing Kegels or not IS NOT relevent to whether one eventually achieves continence, but it IS significant in the time required to regain continence.

There is wide variation in individual results in both study groups.


DaSlink
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Date Joined Feb 2011
Total Posts : 713
   Posted 2/11/2011 4:12 PM (GMT -6)   
Sorry new here but what is GFMPH event?
Every minute you fish or ride,adds an hour to your life!

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 2/11/2011 5:49 PM (GMT -6)   
Anxiety: Still waiting my turn to be dry after 6.5 months, so I am above the 180 day average right at this point.

As some might recall I posted a few times that my kegel exercise routine since late November 2010 has been 10 short 2 second kegels followed by 2 seconds of rest. Then 10 long 10 second kegels with 10 seconds in between each. I do each short and long group laying down, sitting on a chair and then standing. I do them early in the AM before work and then just before bed in the PM.

Funny you should mention the start and stop of voiding in your post. Just for kicks, I starting stopping and starting my stream while voiding and for one, it seems to make my sphincter ache a bit to hold back the flow. I could do it quite successfully, but it gave me a little pain. Did that for about 3 days and suddenly I notice that I was LEAKING more than before. So, I am in agreement that the start stop routine is just to ID the right pelvic floor muscle group and not a way to exercise. Besides, how many start and stop sets can you do in a typical voiding episode. I also have found that if I stop near the end of voiding, I think I am retaining some urine because I suddenly can't go any more and I am almost certain I had some left in me to push out.

So, in my non-medical opinion, I would go for the Dry method of pelvic floor exercising and skip the start and stop while urinating business. Do it only to affirm that you are using the right muscle in the pelvic floor.

Anyone else agree?

On the other hand, I have Partin's discharge notes, even though I had Carter as my surgeon. Actually, I have Hopkin's surgeon's discharge notes. Partin's notes say to do kegel exercise only when voiding. so given his experience, ask him if this is the only way to do the exercise or can you go to the dry version of them. I would hate to suggest you go against Partin's instructions.

Chris R - Did you follow Partin's notes exactly as stated? Carter's notes have the wet voiding kegel only as a way to isolate and ID the muscle group. The exercise Carter recommends is 45 kegels spread out over 3 sessions per day, holding 5 seconds or longer between each.

Anxiety and ChrisR and other Hopkins patients, Would like to start a discussion at some point soon about our shared experiences. Chris R, I am heartened in a way that it took you a year to achieve continence with a surgeon of the stature of Partin. It give me hope that at 6.5 months I may have the same experience and not be discouraged by so many on this site who are finished and done with pads at 6 weeks. Yikes! at 6 weeks I was still at 4 pads per day.
Thanks all, this is a great site with so much warm support and deep wisdom about living life in general.

Mike S.
Dx 56
Biopsy: Gleason 3+3=6, PSA 6.6 One core of 12 with 5% T1c
Surgery: July 2010
Pathology Gleason 6, Neg Margins, Neg Lymph, Neg Sem Vesicles
9/15/10 1st post op PSA >0.1 undetectable
3/11/11 PSA - TBD
Incontinence - very slow recovery
Aug -Sept 2010 - 4-5 pads
Oct 2010 3 pads
Nov 2010 2 pads
Dec - Feb 2011 1 pad all day - pad at night for some small urge incontinence leaks
ED: slow recovery

dogbot
Regular Member


Date Joined Aug 2009
Total Posts : 147
   Posted 2/12/2011 8:50 AM (GMT -6)   
I started kegals several weeks before surgery, and started again when the catheter was removed. I am now nearly 22 months out from Davinci and still do kegals but to a lesser amount than early on in the recovery period.
I was also advised not to do the exercise whilst mid stream, although I have tried it just to satisfy myself that I can actually cut off in mid stream, which I can do quite easily.
I am 99.9% continent now, with no problems in lifting, sneezing or coughing. I have an occassional drop after urination, but I can usually empty the uretha by stroking the scrotum upwards towards the penis which seems to do the trick.
 
All the best from England.

Floyd
New Member


Date Joined Feb 2010
Total Posts : 18
   Posted 2/12/2011 10:57 AM (GMT -6)   
I was a heavy leaker after RRP one year ago and finally slowed after 6 months but still needed one pad per day for the next 4 to 5 months. I became lax in doing the Kegels when I got to this point since I was relieved to be over the 12 plus pads per day period and felt that I could live with one pad per day. I then resumed doing 10 to 20 reps of 10 second duration each to see if I could shed that last pad. Suprisingly I noticed an immediate effect from them, even if I only did 10 reps each morning on the way to work, etc. For the first time in the year since surgery I am pad free. I`m pretty happy with that. I think that they do work. I do not know what the ideal number per day may be, but even my easy regimen seems to have an effect.

Floyd
New Member


Date Joined Feb 2010
Total Posts : 18
   Posted 2/12/2011 11:05 AM (GMT -6)   
DaSlink, sorry I forgot to respond about GFMPH;  this means good for my prostate health. This could include any activity that may be enjoyable and could be justified as "I should do that dear, it would be good for my prostate health."

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/12/2011 12:29 PM (GMT -6)   
Sheldon, I am in your camp on the Kegals. Going dry was not a real issue for me, being able to urinate at all, was a big problem for me as you know. When going dry, I tried kegals one time and one time only, and said, nope, this isn't going to happen. I was dry by the first week, but wore a pad for a month after just for security reason, never did have a mishap.

My doctor said that doing them before surgery was entirely pointless, as a lot of things can change during and after surgery. He also said that some men get to OCD about doing them, and end up overdoing them, defeating the purpose by tiring out the muscles they are trying to strengthen, making things worse.

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

cyclingboy
Regular Member


Date Joined Feb 2011
Total Posts : 32
   Posted 2/12/2011 9:53 PM (GMT -6)   
Hello,
first time here for me in this exclusive club. just underwent ORP about 2 weeks ago. Had my catheter out yesterday, and have been dribbling like a broken faucet since. I seem to be somewhat continent at night (based on 1 night so far). But walking around is a different story. I have been told not to get discouraged the first few weeks, but not finding that so easy.

questions:
1. I have been trying to pee in the toilet every couple of hours, but there is hardly any volume - probably because I am not drinking much (so I won't leak). I am guessing part of the problem is that for the 10 days I was cathetered my bladder shrank since it did not have to hold anything. Am I better off trying to increase volume of liquids a little to try to "tax" my bladder some?

2. along the same lines, should I try to hold it a little longer?

3. Kegels - my doc says do them 4-5 times a day, 10 reps. Seems to me like walking around is one big kegel if I am trying not to leak. I imagine this is tiring out my muscles and not helping? should I just not worry about maintaining control while walking standing?

any words of advice? are the first few days just really crappy with some improvement soon after? I'd like to get back to work in a week and feel like I won;' wet my pants (though the thought of freely wizzing into a pad during certain meetings does have some poetic justice appeal). nono
AB
age 45
PSA 9/2010 = 4.2
biopsy 11/2010 - 3/12 cores positive, Gleason =3+3, 5% volume in positive cores
RP 2/1/2011
post-op path Gleason 4+3, organ confined, lymph nodes clear
waiting for follow-up PSA in 3/2011

DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 732
   Posted 2/12/2011 10:56 PM (GMT -6)   
AB,

Welcome!

1. You should drink enough to stay healthy. Don't worry about not having much volume the day after getting the cath out; your body is still healing.
2. Also don't worry about holding it in longer right now. That too will work better when you're healed more.
3. Kegels are worth doing, as you'll get more muscle exercise than you would from just walking around. But, if you get tired, stop and rest.

Back at work a week from now is kinda early, but some guys do recover faster, and you're younger than many of us so maybe that will work for you. Assuming you don't have to do any heavy lifting at work. I personally have never peed during a meeting at work, but that is an interesting thought.

As you can tell from the many other posts, there is a lot of variation on when continence returns. Some guys get it right away, others are incontinent for 18 months and then suddenly improve overnight. And all sorts of other experiences.

DJ
Diagnosis at 53. PSA 2007 about 2; 2008 4.3
Biopsy Sept 2008: 6 of 12 cores pos; Gleason 4+3 = 7
CT & Bone scan neg
Da Vinci at City of Hope Dec 8, 2008
Rad prostatectomy & lymph node dissection
Cath out on 7th day, in on 8th day, out again 14th day after neg cystogram
Path: pT2c; lymph nodes neg; margins involv; 41 grams,
PSA 1/08, 4/09,7/09, 10/09, 11/09,2/10 <0.01, 10/10 0.1, 2/11 0.08

Ger42
Regular Member


Date Joined Apr 2010
Total Posts : 189
   Posted 2/13/2011 7:18 AM (GMT -6)   
Ab
My doc said to drink lots and lots of water. He said he wanted my urine to be clear every time. I consumed 5-6 20 oz bottles of water everyday. Today I drink 4-5 depending my activities. I try to keep my urine clear. I have cut out coffee out or my morning ritual last week. I'm allowing myself one small cup on Sunday morning. I'll see if that helps.
I did Kegals before and still doing them. Leak now when I stand up after sitting for a long time, not every time. I am working out with weights now and don't leak even when really exerting myself. Strange but I don't leak when I get up each night to urinate but will on occasion leak when getting up after laying down watching TV.
Now if I could only get peter to wake up. (LOL)
Age 68 weight 185 height 6'
Samples taken 4/19/2010 sent to Bostwick
3 out of 12 samples cancer
1) gleason score 3+3 involving 65%
2) gleason score 3+3 involving 65%
3) gleason score 3+3 involving 10%
PSA 3.5 Mar 19
PSA 2.5 Apr 4
Bone scan clean CT scan clean
Da Vinci 10/12/2010 DR Paul Kahn all nerves spared
Home 10/19/20
Cath out 10/22/2010
Prostate 56 gm. Gleason grade 3+4 = 7
2 MO PSA 0.0

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 2/13/2011 10:17 AM (GMT -6)   
The National Assoc. for Continence (NAFC) has a very good pamphlet titled "Keeping the Vital Pelvic Floor Healthy.  Here is a link to their site:  http://www.nafc.org/uploads/pdf/Pelvic_floor.pdf.   I have also include a few excerps from the pamphlet:
 
"After age 40, men and women begin losing muscle at the rate of about half a pound per year, replacing it with fat.  The rate of loss doubles for women after menopause.  Unless an effort is made to prevent this loss of lean body mass through exercise, gradual declines take place in muscular strength and endurance throughout the body, including the internal muscles."
 
"When healthy, all the pelvic floor muscles can be voluntarily controlled. If these muscles become weak, however, the effects can include loss of bladder and even bowel control, loss of pelvic organ support, and diminished sexual enjoyment."
 
"When the pelvic floor muscles lose their strength and endurance, the problems that arise can seriously affect an individual’s quality of life. To prevent or address these problems, exercise that conditions the pelvic floor must become a lifelong habit".
 
I have followed their suggestions for several years and enjoy excellent control.  The pamphlet is easy reading and has recommendations beyond just doing kegels.
 
Carlos

Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, SRT 12/2010.

142
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Date Joined Jan 2010
Total Posts : 6949
   Posted 2/13/2011 11:21 AM (GMT -6)   
AB,
 
Welcome to HW.
 
I also cut back on drinking water because I was just a continuing flood. That eventually had a very negative side effect - several urinary tract infections. Trust me, those are unpleasant.
 
Just as an add on to the work question, my Uro/Surgeon said before surgery to be sure that I could be away from work for 5 - 7 weeks. Because some of my job can be done remotely via phone/computer, I was actually working a few hours a day the next week.
On the other hand, it was two months before my leakage got down to a level at which I was willing to get out much.
 
The link Carlos provides is a good reference.
 
And last, too many Kegels is too many (at least in my experience) - if you see that things get noticeably worse late in the day / evening, either back off a set of kegels, or spread them out more through the day.
DaVinci 10/2009
My IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

cyclingboy
Regular Member


Date Joined Feb 2011
Total Posts : 32
   Posted 2/13/2011 3:29 PM (GMT -6)   
thanks for the advice guys and the useful link Carlos.

I'm noting your advice on returning to work. if needed I can take longer, and yes I also can work remotely. I told my boss 3-6 weeks, and the initial plan was 3-4, but can be extended if needed.

my job is basically a desk job, so no heavy lifting, though typically have a lot of meetings during the day - that's the part for which I will need to have some confidence.
AB
age 45
PSA 9/2010 = 4.2
biopsy 11/2010 - 3/12 cores positive, Gleason =3+3, 5% volume in positive cores
RP 2/1/2011
post-op path Gleason 4+3, organ confined, lymph nodes clear
waiting for follow-up PSA in 3/2011

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 2/13/2011 6:21 PM (GMT -6)   
AB:
While I am still in the continence recovery phase, I am recalling my first few weeks back to work, also a desk based job. I was given parking so that I could have a very short walk from the garage to my desk. Leaked all the way until I sat down. Had to change pads mid day for the first few weeks. I just glued myself to my desk with treks to the bathroom only. Zero percent confidence in doing anything that involved walking around. Lost the temporary parking so I had to walk a mile from the train station to work. Fretted over that for a week and tried to imagine the disaster that would befall me for such a long walk. Even took a trial walk around my home area on the Saturday before I had to do the walk at work. I survived and my pad was only half full on the walk into work. Shortly after the train station walk began, my leaking diminished enough so that I only needed one pad for the entire work day. I changed it on returning home. Several weeks later, the pad worn all day did not have to be changed right after coming home.

Now I just weep more than leak with an occasional spurt if something in my GI system puts some pressure internally within me. From 80 to 60 to 30 and now to around 10 cc of leaking in my pad over a whole work day. Hopefully you will make progress the same way or even better. I am at 6.5 months from surgery and right now progress is slow. However, I note that I am having strings of work days with just under 10 cc of fluid leaked per day. The graph of my progress is looks like a saw blade, but the more under 10 cc days I get, the sooner they hopefully will turn into 5 cc days and then 0 cc days.

So, just take time and read the history of the posts on this site. You will discover a common theme that we can all recite by heart. Incontinence recovery takes time and everyone is different in the rate of recovery.

Specific to your issues:
1. Yes, we all had the feeling that our bladder was never going to hold anything again. At first you will leak it as fast as you can make it but one mystical day will arrive when you notice that when you stand up you don't feel that leaking sensation. That will be the first day you might just have a few squirts to contribute to the toilet. Later you will hold more and squirt some but on average have more to void than you leak. That's progress.

2. Follow your Dr. advice on the Kegels. A total of 40 to 50 does not sound extreme. I have read here somewhere of men who did one big long Kegel every time they walked anywhere. You can try but you will wear yourself out pretty quickly. You have to remember that regaining continence is a two-fold process, the one you don't control and the one you do. The one you don't control is the healing of your internal parts. The one you control is the strengthening of your pelvic floor muscle. Even with a super, beefy pelvic floor muscle, if your internal workings have not healed yet, you will only be able to lessen the leaking but not stop it entirely. So both natural healing and exercise work together to bring this side effect to an end. Unfortunately, you can't rush nature. You will heal when you heal. Eat well, sleep well and exercise. Don't rush getting back to work if you don't have to do so. This is the one time you can use a legitimate excuse to take sick time and every sane supervisor should understand this.

Oh, and try not to look like you are urinating at a meeting. It might make the wrong impression.

Keep reading all the posts. The collective wisdom of the folks here is astounding.

Mike S.
Dx 56
Biopsy: Gleason 3+3=6, PSA 6.6 One core of 12 with 5% T1c
Surgery: July 2010
Pathology Gleason 6, Neg Margins, Neg Lymph, Neg Sem Vesicles
9/15/10 1st post op PSA >0.1 undetectable
3/11/11 PSA - TBD
Incontinence - very slow recovery
Aug -Sept 2010 - 4-5 pads
Oct 2010 3 pads
Nov 2010 2 pads
Dec - Feb 2011 1 pad all day - pad at night for some small urge incontinence leaks
ED: slow recovery

cyclingboy
Regular Member


Date Joined Feb 2011
Total Posts : 32
   Posted 2/14/2011 9:48 AM (GMT -6)   
thanks for the advice Mikes24.
sounds like you and some others weigh pads to determine leakage rate. I might just give that a try.
AB
age 45
PSA 9/2010 = 4.2
biopsy 11/2010 - 3/12 cores positive, Gleason =3+3, 5% volume in positive cores
RP 2/1/2011
post-op path Gleason 4+3, organ confined, lymph nodes clear
waiting for follow-up PSA in 3/2011

Inspector 13
Regular Member


Date Joined Feb 2011
Total Posts : 181
   Posted 2/14/2011 10:11 AM (GMT -6)   
One thing that helps me with doing the Kegels is a stop watch type timer. I do the 10 second contractions and 10 second relaxation. Contract on 0 to 10 seconds, relax on 10 through 20, contract on 30 through 40, and so on. At each minute you have completed 3 contract - relax cycles. Keeping the length of time consistent for the contract - relax cycles is easy as well as keeping track of how many contract - relax cycles have been done. I tried to keep track in my head but distractions were too frequent and I would lose track of what I was doing. The timer I use is a left-over from the days my kids were in soccer and it is now helping out the "old guy".

Da Vinci 01/06/10

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 2/15/2011 1:05 PM (GMT -6)   
Since reading every ones post,it appears I may not be going to work for a while unless some thing magical happens before the first of April.
I work in the construction field. I install automatic fire sprinklers and I'm in the largest sprinkler union in the nation. This job requires a lot of heavy lifting, which may pose a problem.
As long as the leakage slows down enough for catfishing, I guess I'll be ok. The doc already told me no Harley riding till April, but that is really when the season starts any way. I must admit,when I an able to ride and I'm wearing a pad, the women will surely look at me differently and wonder. If they only knew that, that isn't all my package!
Every minute you fish or ride,adds an hour to your life!
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